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Individual

EMMY ROSINE MATHEW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
527 MEDICAL PARK DR, BRIDGEPORT, WV 26330-9008
(681) 342-3641
Mailing address
1685 HOLLY AVE, NORTHBROOK, IL 60062-5021
(224) 616-4591

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
03/22/2023
Last updated
03/22/2023
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